Effectiveness of road traffic crash first-aid education on knowledge, attitude, and self-reported practice among commercial motorcyclists in Kigali-City, Rwanda

The burden of road traffic crashes (RTCs) claims many lives worldwide, and survivors may remain with disabilities. In Rwanda, RTCs commonly occur in the capital city, particularly among commercial motorcyclists, who are the most common mode of public transportation. Ideally, first aid, a rapid and life-saving procedure, should be provided immediately after the RTCs while awaiting the arrival of Emergency Medical Services (EMS) to transport the victims to the hospital. However, EMS are scarce in low-income countries like Rwanda, leaving bystanders and laypersons as the main key players in managing the victims after RTCs. This study aims to evaluate the effectiveness of road traffic crashes first aid education on knowledge, attitudes, and self-reported practice (KAP) among commercial motorcyclists working in Kigali City, Rwanda. We conducted a randomized control trial in three districts of Kigali city. The participants were 200 male commercial motorcyclists. This job only requires having a driving license. Participants were selected and grouped according to their districts and randomly allocated to either the intervention or the control group. The intervention group received training on the RTCs module for first-aid, derived from guidelines on essential knowledge and skills for prehospital care providers designed by the World Health Organization and the International Federation of Red Cross and Red Crescent Societies. The control group received a module on Tuberculosis health education. We used a structured questionnaire adapted from the studies conducted in Tanzania. The questionnaire compared the outcome in terms of KAP toward RTCs between the two groups immediately after the training and four months from the completion of the training. The SPSS version 25 was used to analyze data, while Chi-square was used to determine the relationship between socio-demographic characteristics and KAP level. Furthermore, Generalized Estimating Equations (GEE) were used to evaluate the effect of road traffic crashes' first aid education on KAP after the intervention, within and between the intervention and control groups. The findings showed that most participants had a poor knowledge level (87.5%), positive attitudes (74.5%), and poor self-reported practice (51.5%) at the baseline. Previous first aid training, the year they attended first aid training, education level, being a member of the Red Cross, and awareness of emergency call numbers for police were statistically associated with the KAP level of participants. The GEE results showed a significant difference concerning KAP between the intervention and control groups. When comparing knowledge, attitudes and practices (KAP) scores over different time intervals, participants showed notably higher scores immediately after the intervention and during the four-month follow-up compared to the baseline. Furthermore, when examining KAP scores between the intervention and control groups at various time points, Generalized Estimating Equations (GEE) revealed significant differences in scores, as well as interactions between the groups and interval times. In conclusion, first aid education among motorcyclists in Kigali can boost their KAP intention to practice adequately for RTC rescue. Moreover, this level of KAP is maintained after four months of training. Therefore, we can recommend this training and repeat it after more than four months to guarantee a bystander workforce who may support the victims of the RTCs in Kigali-City, Rwanda.

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